Test accurately rules out heart attacks in the ER

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WASHINGTON — A simple test appears very good at ruling out heart attacks in people who go to emergency rooms with chest pain, a big public health issue and a huge worry for patients.

A large study in Sweden found that the blood test plus the usual electrocardiogram of the heartbeat were 99 percent accurate at showing which patients could safely be sent home rather than be admitted for observation and more diagnostics.

Out of nearly 9,000 patients judged low risk by the blood test and with normal electrocardiograms, only 15 went on to suffer a heart attack in the next month, and not a single one died.

“We believe that with this strategy, 20 to 25 percent of admissions to hospitals for chest pain may be avoided," said Dr. Nadia Bandstein of the Karolinska University Hospital in Stockholm. She helped lead the study, published in the Journal of the American College of Cardiology.

Chest pain sends more than 15 million people to emergency rooms in the United States and Europe each year, and it usually turns out to be due to anxiety, indigestion or other less-serious things than a heart attack. Yet doctors don't want to miss one — about 2 percent of patients having heart attacks are mistakenly sent home.

People may feel reassured by being admitted to a hospital so doctors can keep an eye on them, but that raises the risk of picking up an infection and having expensive care they'll have to pay a share of, plus unnecessary tests.

The study's results are “almost too good to be true," said Dr. Judd Hollander, an emergency medicine specialist at the University of Pennsylvania.